Health Conditions Linked to Psoriasis

Living with psoriasis puts you at risk for a variety of complications, some of which may surprise you.

The reason psoriasis can lead to other problems is rooted in the inflammation and, in some cases, insulin resistance associated with the condition, explains Valori Treloar, MD, a dermatologist with Integrative Dermatology in Newton, Massachusetts.

"Insulin does a lot of things that are harmful when it's in excess," Dr. Treloar says. "Definitely excess insulin [has been linked to] metabolic syndrome, heart disease, cancer, and so on."

Jeffrey M. Weinberg, MD, an associate clinical professor of dermatology at Mount Sinai School of Medicine in New York City, agrees that “there are multiple comorbidities” linked to psoriasis. He lists psoriatic arthritis, depression, inflammatory bowel disease, and diabetes among them.

Here are eight conditions that are commonly associated with psoriasis:

1. Psoriatic Arthritis

Many people with psoriasis develop psoriatic arthritis. The more severe your psoriasis, the more likely you are to get psoriatic arthritis.

The challenge is identifying this psoriasis complication early on, to gain better control of the arthritis before it damages the joints or causes permanent disability.

2. Pregnancy Complications

These and other complications could be the result of inflammation or the continued use of certain psoriasis treatments. Restasis (cyclosporine), for example, is an immunosuppressive drug approved for adults with severe psoriasis, but there is evidence that it can harm a developing fetus.

3. Polycystic Ovarian Syndrome

Polycystic Ovarian Syndrome (PCOS) is a condition of the female reproductive system that causes small cysts or tiny sacs of fluid to form on the ovaries. PCOS is known to increase a woman’s chances of developing endometrial cancer.

PCOS contributes to infertility and also affects the skin, sometimes increasing adult acne and male-pattern facial hair in women. PCOS and psoriasis treatments might include hormones, metformin, and changes in diet and exercise habits.

4. Depression

Depression as a psoriasis complication could arise from quality of life issues relating to body image concerns and physical discomfort. According to the National Psoriasis Foundation, 63 percent of all people with psoriasis say the disease greatly affects their emotional well-being.

5. Metabolic Syndrome

Metabolic syndrome is a condition characterized by high blood pressure, increased waist circumference, elevated blood sugar levels due to insulin resistance, and elevated blood fats.

Whether psoriasis predisposes people to metabolic syndrome or vice versa remains unclear, but researchers stress that “patients with psoriasis should be encouraged to aggressively address their modifiable cardiovascular risk factors.”

6. Heart Disease

“Chronic inflammation has long been associated with an increased risk of heart attack and stroke,” says Kevin R. Campbell, MD, cardiologist at North Carolina Heart & Vascular iand assistant professor of medicine at the University of North Carolina in Raleigh. That's because inflammation can damage arteries.

If you have psoriasis, it’s important to monitor your heart health and take steps, such as following a healthy diet and exercise program, to protect against cardiovascular disease.

“I make the point of saying the first-line treatment for psoriasis is diet and lifestyle,” says Treloar.

7. Chronic Obstructive Pulmonary Disease

The inflammation associated with psoriasis can affect the lungs and raise the risk for chronic obstructive pulmonary disease (COPD). COPD is a group of lung conditions or diseases that block airflow and make breathing difficult.

People with psoriasis should avoid COPD risk factors, such as smoking and lung irritants like air pollution, chemical fumes, and dust. Doctors should test at- risk patients early for reduced lung function.

8. Cancer

“Psoriasis is a condition that alters your immune system in such a way that overall inflammation is increased, which can slightly increase your risk of developing cancers," says Stephanie Fabbro, MD, dermatologist at Buckeye Dermatology and assistant professor at the Wexner Medical Center at The Ohio State University in Columbus.

Studies suggest that psoriasis increases your risk for developing certain types of cancer, including skin cancer and lymphoma.

“It remains unknown what exactly puts [people] at greater risk,” says Junko Takeshita, MD, PhD, assistant professor of medicine and a postdoctoral research fellow in the department of dermatology at the Perelman Center for Advanced Medicine at Penn Medicine in Philadelphia. Studies suggest that chronic inflammation associated with psoriasis can promote the growth of tumors.

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